Skip to Main Content Skip to Site Map Skip to Accessibility Statement Levodopa

1st choiceCo-beneldopa (Madopar®) containing levodopa and benserazideDose:
See BNF - seek specialist advice
Co-careldopa (Sinemet®) containing levodopa and carbidopaDose:
See BNF - seek specialist advice

Prescribing Notes

  • To reduce the risk of nausea, start with a low dose and build up slowly. Levodopa should not be withdrawn abruptly. It may colour urine red.
  • Levodopa is a useful first line drug for older/frail patients to optimise control faster.
  • Levodopa containing preparations are normally prescribed as their individual components, however, be aware that the total dose is sometimes referred to e.g. Madopar 50mg/12.5mg as Madopar 62.5mg.
  • Co-beneldopa (Madopar®) and co-careldopa (Sinemet®) are used equally and there is no evidence of benefit of one over the other.
  • Dispersible Madopar® may be useful where rapid absorption is desired, for example first thing in the morning. Patients should be advised to dissolve in plenty of water; often an inactive sediment remains in the glass.
  • Modified-release formulations of levodopa are not recommended for initiation of therapy. They may be useful for nocturnal immobility and rigidity e.g. some patients are prescribed a modified release preparation at night and immediate release preparations during the day.
  • For driving advice, see general notes (cautions).